Couples Therapy for Domestic Violence
Recruiting in Palo Alto (17 mi)
Overseen byGunnur Karakurt, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University Hospitals Cleveland Medical Center
Must be taking: Psychotropic medication
Disqualifiers: Severe violence, Firearms, Substance misuse, others
Trial Summary
What is the purpose of this trial?
The purpose of this study is to understand whether the couple therapy that is used in practice is effective in preventing situational couple violence. More specifically, investigators will focus on couples with mild to moderate forms of situational couple violence to investigate how couples therapy can be effective in preventing the escalation and recurrence of situational couple violence. For this purpose, the response of partners to therapy will be investigated by integrating self-report questionnaires and psycho-physiological markers of emotion.
Will I have to stop taking my current medications?
The trial does not require you to stop taking your current medications as long as you have been stable on them for the past 12 months and have not been hospitalized for psychiatric reasons in the past 2 years.
What data supports the effectiveness of the treatment Couples Therapy for Domestic Violence?
Research suggests that couples therapy can be as effective as traditional treatments for domestic violence, without increasing the risk of harm to women. Additionally, couples therapy has been shown to reduce relationship distress and improve emotional and behavioral health in various contexts.12345
Is couples therapy for domestic violence safe?
How is Couples Therapy for Domestic Violence different from other treatments?
Couples Therapy for Domestic Violence is unique because it involves both partners in therapy sessions, focusing on improving the relationship and communication, rather than treating individuals separately. This approach is considered in cases of mild-to-moderate violence where both partners wish to stay together, and it aims to address the dynamics of the relationship that contribute to violence.378910
Eligibility Criteria
This study is for heterosexual couples over 18 years old who have been in a relationship for at least one year and experience mild to moderate situational couple violence. Both partners must be willing to undergo therapy together, aiming to stay in the relationship. They should not have severe intimate partner violence or history of violent offenses, and they must be stable on any psychotropic medication for the past year.Inclusion Criteria
My partner and I are both over 18.
Couples must have mild to moderate forms of situational couple violence
My partner and I are both participating in this study together.
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Exclusion Criteria
Couples will be excluded if there is a discrepancy between partners' reports of violence in the Conflict Tactic Scale
Participants will be excluded if currently suicidal and/or psychotic and/or moderately ill at the pre-screening
Participants who are not literate or cannot speak English will be excluded
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Waiting Period
Control group undergoes an 8-week waiting period before starting therapy
8 weeks
Treatment
Couples receive therapy to prevent escalation and recurrence of situational couple violence
8 weeks
Follow-up
Participants are monitored for changes in IPV and psychophysiological regulation
4 weeks
Treatment Details
Interventions
- Control (Other)
- Couples Therapy (Behavioral Intervention)
Trial OverviewThe trial investigates if couples therapy can prevent escalation and recurrence of situational couple violence among couples with mild to moderate issues. It involves self-report questionnaires and psycho-physiological markers to assess emotional responses before and after therapy sessions.
Participant Groups
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Couples TherapyExperimental Treatment1 Intervention
Couples Therapy
Group II: ControlPlacebo Group1 Intervention
Couples Therapy after an 8 week waiting period
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University Hospitals Cleveland Medical CenterCleveland, OH
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Who Is Running the Clinical Trial?
University Hospitals Cleveland Medical CenterLead Sponsor
Keming GaoLead Sponsor
National Center for Advancing Translational Science (NCATS)Collaborator
National Center for Advancing Translational Sciences (NCATS)Collaborator
References
Current status and future directions in couple therapy. [2011]Couple therapy research affirms that various approaches to couple treatment produce statistically and clinically significant improvement for a substantial proportion of couples in reducing overall relationship distress. Recent studies have extended these findings in indicating the effectiveness of couple-based interventions for a broad range of coexisting emotional, behavioral, or physical health problems in one or both partners. In contrast to these encouraging results, research also indicates that a sizeable percentage of couples fail to achieve significant gains from couple therapy or show significant deterioration afterward. Research on processes of change and predictors of treatment outcome in couple therapy provides preliminary evidence regarding factors potentially contributing to variable treatment response. The chapter concludes with 12 recommendations regarding future directions in couple therapy research and clinical training.
The Norway Couple Project: Lessons Learned. [2019]Couple therapists in routine practice may find it difficult to apply findings from an increasingly expanding and complex body of couple therapy research. Meanwhile, concerns have been raised that competency in evidence-based treatments is insufficient to inform many practice decisions or ensure positive treatment outcomes (American Psychological Association Presidential Task Force on Evidence-Based Practice, American Psychologist, 2006, 271). This article aims to narrow the research/practice gap in couple therapy. Results from a large, randomized naturalistic couple trial (Anker, Duncan, & Sparks, Journal of Consulting and Clinical Psychology, 2009, 693) and four companion studies are translated into specific guidelines for routine, eclectic practice. Client feedback, the therapeutic alliance, couple goals assessment, and therapist experience in couple therapy provide a research-informed template for improving couple therapy outcomes.
Effectiveness of couples treatment for spouse abuse. [2019]Despite its controversy, carefully conceptualized and delivered couples treatment appears to be at least as effective as traditional treatment for domestic violence, and preliminary data suggests that it does not place women at greater risk for injury. However, the body of research on which these conclusions rest is sparse. Only six experimental studies have been done, each using different eligibility criteria, outcome measures, and treatment approaches. Thus, further study of this modality is warranted. Marriage and family therapists have an important part to play in continuing to develop and test innovative ways of helping couples end violence and improve their relationships--an endeavor that promises to improve the quality of the partners' lives as well as those of their children.
Outcomes in couple therapy: reduced psychiatric symptoms and improved sense of coherence. [2006]In Sweden, only a few empirical studies of couple therapy have been performed. This is the hitherto most comprehensive assessment of clinical treatment. Effectiveness of treatment is reported and compared with non-clinical ratings. Initially the couples displayed marital distress, many psychiatric symptoms, dyadic interactions characterized by high criticism and a low sense of coherence. In Sweden, couple therapy is primarily aimed to reduce marital distress and does not focus on individual disorders. It should be seen as innovative that overall psychic symptoms (Global Symptom Index, GSI) as well as depressive symptoms were reduced (more than one standard deviation) for both women and men to the extent of 50-55%. Normal values were attained by 73-78%. Of those who initially identified a low sense of coherence, 22% of the women and 37% of the men improved (more than one standard deviation). Normal values were attained by 68-70%. The treatment was relatively short, which meant that, with relatively limited treatment, it was also possible to attain relatively significant improvements in all dimensions of psychiatric symptoms.
Effectiveness of Couple Therapy in Practice Settings and Identification of Potential Predictors for Different Outcomes: Results of a German Nationwide Naturalistic Study. [2021]Even though couple therapy is efficacious, there is no improvement in up to 50% of the couples. Also effect sizes found in effectiveness studies in real-world settings are considerably lower than those found in efficacy studies. There is a need to understand more about couple therapy effectiveness in practice settings and the factors responsible for different outcomes. A German nationwide study on the effectiveness of couple counseling including 554 couples applied the same methodology as two earlier studies in the same field. A remarkable consistency was found over the three independent studies in the burden with individual and relationship distress as well as in the rates of improvement. This supports the insight that the improvements reached through couple therapy in practice settings are only about half of the effect sizes reached in efficacy trials. Additionally this study investigated 64 factors, which were found to be influential for relationship quality and stability in earlier studies, for their impact on outcome. Factors present at initiation and termination of therapy were found, which correlate significantly with outcome and with separation of the couple in the follow-up. These factors could be included in prediction models for improvement and separation of the couple. The implications for the practice of couple therapy and for future research are discussed.
Single- and dual-trauma couples: clinical observations of relational characteristics and dynamics. [2004]Trauma survivors and their spouses/partners who seek therapy often present with unique dynamics owing to the ongoing effects of previous trauma. This article provides a clinical framework for understanding single-trauma (only 1 partner reports a trauma history) and dual-trauma (both partners report a trauma history) couples. The descriptions of single- and dual-trauma couples were developed through several focus group discussions. Interpersonal patterns characteristic of single- and dual-trauma couples are described. We emphasize the importance of using a "trauma lens" when working with couples and families to avoid overlooking important cues about the individual and systemic effects of traumatic stress.
Domestic violence assessment procedures among couple therapists. [2015]Guidelines for addressing domestic violence (DV) in couple therapy have been published, but reports of whether therapists routinely follow these suggestions are few. A national survey of 620 couple therapists randomly selected from American Association for Marriage and Family Therapy members was conducted in 2000 to assess therapists' strategies for assessing DV and selecting a treatment modality when violence is discovered. Less than 4% of respondents indicated consistently following key published guidelines for DV screening (universal screening using separate interviews and questionnaires). A minority indicated that they consider the victim's safety as a factor in treatment modality selection. DV may be under-identified by couple therapists and therapists may be using conjoint therapy with couples for whom such therapy is contraindicated because of relationship violence.
Battering and couples therapy: universal screening and selection of treatment modality. [2019]As family therapists begin to experiment with couples treatment models for batterers and their partners, a basic question is: Which couples can be safely treated with conjoint therapy? Following a definition of battering and a review of rationales for considering couples therapy in cases of domestic violence, a framework for assessment of domestic violence is outlined, including sample questions, criteria for excluding couples from conjoint therapy, how to conduct a lethality assessment, and how to conceptualize postassessment treatment recommendations. This article also introduces family and couples therapists to domestic violence literature that is often not well integrated in family therapy theory and practice.
Developing a manualized couples treatment for domestic violence: overcoming challenges. [2019]This paper describes challenges faced in a four-year project to develop a manualized couples treatment program for domestic violence. The couples treatment program is an add-on to a male batterer program where the male partner has perpetrated mild-to-moderate violence, yet both partners want to remain together. The project involved the cooperation of a variety of community agencies and referrals from key domestic violence programs. While some anticipated challenges did not materialize over the course of the project, unanticipated challenges did. Qualitative data collected from therapists and clients throughout the project was used to refine the treatment approach.
Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis. [2019]Intimate partner violence is a serious public health problem accompanied by substantial morbidity and mortality. Despite its documented impact on health, there is no widely recognized treatment of choice. Some studies indicate that couples suffering from situational violence may benefit from couples therapy, but professionals are cautious to risk the possibility of violent retaliation between partners. After a comprehensive literature search of 1,733 citations, this systematic review and meta-analysis compiles the results of six studies to investigate the effectiveness of couples therapy as a treatment for violence. Preliminary data suggest that couples therapy is a viable treatment in select situations.